HomeMy WebLinkAboutBLD2012-00160 Pole Bldg - BLD Permit / Conditions - 3/23/2012 w Inspection Line tams/4�i-i�n�
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
'7001
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2012-00160
OWNER: LES OKONEK RECEIVED: 3/23/2012
CONTRACTOR: TOWN &COUNTRY BUILDINGS 1-800-824-9552 LICENSE: TOWNCPF099LT EXP: 6/30/20, ISSUED: 5/24/2012
SITE ADDRESS: 283 E OKONEK RD GRAPEVIEW EXPIRES: 11/24/2012
PARCEL NUMBER: 121082400000
LEGAL DESCRIPTION: G.L. 2*&TAX 652*,652A-1* S 27/244
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
GARAGE-POLE BUILDING STOCK PLAN 2009-0001 FROM GRAPEVIEW LOOP RD TURN SOUTH ON OKONEK RD FOLLOW TO
END PROPERTY IS ON LEFT HAND SIDE
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U Lot'Size: Deck:
Type of Work: ACC Fire Dist.: 3 No.of Stories: 1 Occ. Load: Building: Garage-Detached 1,536
Valuation: $ 60,912.40 Building Height: 21 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: W 20.0 Ft. Shoreline: Ft. Water Body: na
Rear: E 135.0 Ft. Slope: Ft.
SEPA?: No
Model: Width: Ft. Side 1: N 2 1.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: I Side 2: S 105.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Plan Check Fee TW 3/23/2012 $463.94 S1201200000001
Plan Check Fee TW 3/23/2012 $4.55 S1201200000001
Planning Review Fee TW 3/23/2012 $205.00 S1201200000001
ADJUST--Plan Check Fee TW 3/23/2012 $-324.34 S1201200000001
EH Plan Review KKK 3/26/2012 $ 103.00 S6201200000001
Building State Fee LDK 4/19/2012 $4.50 S1201200000001
Building Permit Fee LDK 4/19/2012 $720.75 S1201200000001
Total $ 1,177.40
BLD2012-00160 Please refer to the following pages for conditions of this permit. Page 1 of 5
CASE NOTES FOR
BLD2012-00160
CONDITIONS FOR
BLD2012-00160
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0982. T>�person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) Owner/Agent iM
bl e to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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3) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Department prior to any further inspections being performed or approvals granted.
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4) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of approvegl.doents will result in failure of required building inspections.
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5) This structure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use
permit shall be applied for, reviewed and approved prior to the change.
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6) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X �Ao
7) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Department prior to any further inspections being performed or approvals granted.
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8) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the
manufacturer's installation instructions.
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BLD2012-00160 Please refer to the following pages for conditions of this permit. Page 2 of 5
9) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic
system of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final
inspection of the building permit the owner/agent/contrac�W,�rr is acknowledging that all components of the stormwater management system have been
installed as approved on the stormwater site plan. X AO�!
10) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/Reserve requires a 10ft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. No foun ation drains within 30ft, down gradient of drainfield/reserve area.
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11) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the
international codes and Mason County Regulations unless a"Change of Use" permit is applied for, reviewed and approved.
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12) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
charged an �4all be collected by the Building Department prior to any further inspections being performed or approvals granted.
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13) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation.��PI
14) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact
adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the
stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further
information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access
connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which
is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may
affect your project.
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15)- Placemen of structure must comply with standards set forth per the international codes regarding descending and/or ascending slopes.
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BLD2012-00160 Please refer to the following pages for conditions of this permit. Page 3 of 5
_215) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance o regulation, must be reviewed and approved by Mason County prior to construction.
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17) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
X spector shall la? prior to requesting additional inspections.
18) All property lines shall be clearly identified at the time of foundation inspection. X
19) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason County ordinances and building regulations.
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20) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prevented action from being taken. No more than one extension may be granted.
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21) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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22) Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X OW10
23) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure
these structures meet the setback conditions listed.
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24) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed.
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25) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X_ Z:9 'te
26) Approved dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
BLD2012-00160 Please refer to the following pages for conditions of this permit. Page 4 of 5
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27) , ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD WAY. 7 X X
28) Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Rural Residential 5.
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29) This structure has NOT been reviewed or approved as an Accessory Dwelling Unit(ADU): A second dwelling unit detached from an existing single-family
dwelling for use as a completely independent or semi-independent unit with provisions for cooking, eating, sanitation and sleeping. ADUs are required to
meet the requirements under Mason County Development Regulations 17.03.029. X ?Ea4
This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any
time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be
occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate
and grants employees of MasonCounty access to theabove described property and structure for review and inspection.
OWNER OR AGENT: J`�C��% � `%�� DATE:
BLD2012-00160 Please refer to the following pages for conditions of this permit. Page 5 of 5
N CONCRETE MECHANICAL MANUFACTURED HOME
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N Footings I Setbacks Date BY Ribbons Z
Gas Piping
o Interior Date By Interior-Date By Data By ITl
rn Exterior Date $ .L�_ L By /` Exterior-Date B
CD Set-up r
Point Load 1 Isolated Footings INSULATION Date BY Cl)
I SLAB INSULATION
Date By Data By FIRE DEPARTMENT
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING Vault Date Ely
Da1e By OTHER
Groundwork Attic
Date By Date By Type.Date By
D W V DRYWALL Type-
Date By
Int.Brace Wall Date By
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CD Date By FINAL INSPECTION 0
y Water Line Fin Separation N
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Pe" �2 MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98564
(360) 427-9670
CORRECTION NOTICE
Job Location 2- e-3 �iF��- ��Ae
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items listed below must be corrected to gain compliance
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You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
Call for re-inspection when corrections are made before continuing Lj please contact our office
Make corrections, items will be checked on next inspection regarding possible structural
OK to damage incurred by recent
"natural/man made"
This is not a complete inspection disasters.This is NOT a
Date -`--- - / Department CORRECTION NOTICE.
Inspector
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NOT , i•�1� �4 ' THP& T' * mw
Permit MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTIC
Job Location -2- R3 /yj�e
This structure has been inspected by Mason County Building Departm
and the following VIOLATION of County Laws and Ordinances has been
found: Items listed below must be corrected to gain compliance
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You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
Call for re-inspec on when coy
tiqng� re made before continuing
Tfl ��/y//�/� ` ❑ Please contact our office
❑ Make correctilrns, iten s will be checked on next inspection regarding possible structural
jk3 OK to z" .D_ damage incurred by recent
O�y �� SU "natural/man made"
❑This is not a complete inspection 1g disasters.This is NOTa
_ E_0- ►r/I%lf�'-� I CORRECTION NOTICE.
Date Z �Z Department D
Inspector=d
s ,004 Nk ,#T , M0 ,0V ' THI T A G
08/17/2012 FRI 11: 09 FAX 425 742 4378 PERMABILT 0001/004
Town & Country Post Frame Buildings ,
16521 Hwy. 99 suite C
Lynnwood WA. 98037
1-800-824-9552
425-743-1555 fax425-742-4378
Fax Transmittal
Date: 8/17/12
To: Debra
Faxed to: 360-427-7798
From: Rob Burns
# Of pages including cover (3)
Special instructions:
Attached is the letter from our engineer concerning the corrections on 8/2/12 for permit
#BLD2012-00160. Please review items and let me know what items are not addressed.
Thank you.
1. Re inspection fee will be paid prior to next inspection
2. Item#1 concerning plan size, as per our conversation these are the normal plan
size submitted and if there are either schedules or details that need addressed, the
Foreman will be on site to answer any questions you may have.
3. Item #1 a—approved plot(site)plan and green insp. Card will be on site prior to
next inspection
4. Item#lb—there are only a total of 4 pages for this particular building, 3 will be
for the plans and 1 will be the plot or site plan.
5. Item#lc—This has been addressed in the engineer letter attached.
6. Item#2—All holes will be clean of any excess material prior to placement of 6"
punch pad. Question-Would you like the punch pad installed prior to footing ,
inspection? o^�� L jf�r/7
7. Item#3 —This has been addressed in the engineer letter attached.
8. Item#4—this will be the owner's responsibility to address, own and Country is
on responsible for the Building. ip�-f- �pp jn Yl U+'
Thank you
re
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08/17/2012 FRI 11: 10 FAX 425 742 4378 PERMABILT IL002/004
R E C E I E D '
AUG 14 2
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A Engineering's MEMO
DATE: 8/14/12 Page 1 of 2
TO: Building Official
FROM:Terry Powell, P.E., Principal
SUBJECT. "Okonek" Post Frame Building
283 East Okonek Rd
Grapeview, WAS
The engineering calculations submitted for the referenced building are for a typical 40' x 80' i
building with similar bay spacing as this building. These calculations qualify the engineering C'y
requirements for this specific building with the exception that straps per the detail below are
to be added to the 8' bay at the east endwall (see page 2 for location on building design). �\
In regards to the top of bored holes which "sluff' off at the top, the backfill and compaction ``'
specifications stated in note 9 still apply and are to be followed. The resulting embedded X
post will be adequate.
Where compacted fill has been placed on building site (see letter from S&T const dated
8/7/12) the posts are to be embedded into native earth per plan and detail 1312.
2-10d x 1-1/2'NNLS
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12810 N.E. 178th Street, Ste 218 ♦ Woodinville, WA. 98072 ;
(425) 481-6601 1 terfy@tse-aep.com
08/17/2012 FRI 11: 10 FAX 425 742 4378 PERMABILT 10003/004
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BUILDING ELEVAIIGN
Ckitouur has vattSM acd�prowd the aneatatwn of fhe Uudd,ag to Ux Nath cnA varlflm:tlut alt uefns cpoa tied,n Pa[agr9{,FI B af�C���wln�cad v�ca�pRe
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08/17/2012 FRI 11: 11 FAX 425 742 4378 PERMABILT Z004/004
mob 2.31 13 Sb
S & T Construction
421 NE Anvil LN
Belfaxr, Washington 98528
360-372-2793
Town and Country August 7, 2012
Attention Rob Burns
800-824-9552 Fax 425-742-4378
Rob Cell 425-300-8304
E-mail fleldsupernorth@permabilt corn
Mr Burns,
Concerning Mr Les Qkonek project at Grapeview, Washington
Compacting material was applied and compacted 1 foot depth at a time to building site
pad, the added matenal is between 1 to 3 foot deep This is material that has been
approved at other sites for Town and Country in the past
I was requested by Town and Country building contractor to bnng in extra matenal to be
applied at the nght hand corner to have the area extended to a four foot buffer from
building This material was not compacted
If you have any questions please contact me at 360-551-6833 or 360-372-2793 You may
also e-mail me at stconstlloydsegar ,lotrnacl corn
Thank you
H Lloyd Segar
Quality work at a fair price
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MASON COUNTY PERMIT NOP� 02,Df 2.-W (00
BUILDING PERMIT APPLICATION
426 W. Cedar • P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Les kG��k Company Name N-4C6, - k o� ers
Mailing Address FQ SkoX 16 Mailing Address ! C_
City G1 v:c w State WA Zip Code 9R 5y(- City State A Zip Code 5k0 3-7
Phone _Ak0-30-b-S Z Other Ph. Phone yZs-7y3- /5515 Other Ph.
Lien/Title Holder Contractor Reg. # c c �(x �p. /3
E mail address E Mail Address ncrw1�5 .�nerw�+ib.01 fr'W7
Drivers Lic. # DOB Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic X
Connect to Water System Name of Water System
Well Y_Water System Name of Water System
PARCEL INFORMATION - 12 Digit Parcel No. 12\0 R2y00000 Fire District
Legal Description C,- L. Z -t 7Ae (-57- _ (.,5ZA-1 S Z-i /Ztiy 5 35`t4t s .3co f/vo
Site Address (Please include street name, street number and city) 21,31 F_
Directions to site 110
L S
Will timber be cut and sold in parcel preparation? Yes/ o
Is property within 200' of Saltwater X _Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement action? Yes
TYPE OF JOB - New Add Alt Repair Other PRIMARY RE ID NCE [K SEASONAL ❑
Use of Building GCwm C_ Describe Work Cos rICItl 1%53Cs SF Jckc C...k.,4
V
No. of Bedrooms No. of Bathrooms Square Footage - 1st Floor 2nd Floor
3rd Floor Basement Deck C vered Deck Other Sq. ft.
arag Attached Detache Carport Attached Detached
MAN QME INFORMATION - Make Model Year
Length Width Serial No. — -- No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ ``Re -n pfacereat_UNi? Yes/No
Installer Name Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties. If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. ) '
X rZ Date: 3/fib;IZ
Ow r/Owners Representative ontraclo indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: i." ' Dated 2.
DEPARTMENTAL REVIEW APPROVED I DENIED NOTES
Building Department -/ f.1Z _ L�OC
Planning Department E
Environmental Health Department
Public Works Department
Fire Marshal
FEES
Buildinq Permit Fee Site Inspection
Plan Review Fee EH Review Fee �-
Plumbing & Base Fee Planninq Review Fee �J
Mechanical & Base fee Other
Wood/Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal �-
Valuation $ TOTAL FEES
MASON COUNTY Mason County Permit Center Use:
DEPARTMENT OF COMMUNITY DEVELOPMENT DDR -
411 N.Fifth Street/P.O. Box 279, Shelton WA 98584
360.427.9670 ext. 352 Date Rcvd
Request for
Administrative Variance for Reduction in the Required Setbacks ($115.00)
For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including,roof eaves and gutters.
Applicant/Owners: Z_-:
Mailing Address: 7211
City: Aq c(4 State: ,J�l/L Zip: S U
Telephone:
Email: (' ►a . Cam,..
If this reduction is tied to a building permit, please give permit case number.
BLD 701 3 - 0 006
Parcel Number(s): /z Zq- 0 0 0 00 Zoning
Site Address: -3 _ Mgzl=_ke�J
Requested setback variance:
/O ft. ❑ Front ❑ Rear Side
ft ❑ Front ❑ Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks—From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks—From the rear property line. Minimum 10 feet.
Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, set backs to all
property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
IACommunity DevelopmentTACNARIANCES\Admin Variance.doc Edited on 7/16/10
FRONT AND OR REAR YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) One of the following exists on the lot (check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-fourth acre,
❑ e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) O e of the following exists on the lot (check all that apply):
a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ ) lot size of no more than one-half acre;
VP e) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
b s o Zo
Alo Jae
Owner/Agent (please indicate) r�
i ature Date
Official Use Only
Approved by: Date
Denied by: Date
Reason for denial:
IACommunity DevelopmentTACNARIANCES\Admin Variance.doc Edited on 7/16/10
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